Reply to commentaries

I am delighted that we have had five such thoughtful and helpful commentaries on my critique. To précis the replies they all say that the ideas I put forward are generally sound and also offer further evidence to support some of them. The natural experiment that Robin Room cites where two cities in the Low Countries utilized quite different approaches during the European 2000 football championship is especially telling, being so recent.

All five commentators also make the point that to effect almost any of the suggestions I made would require a significant change in political will. The example of double standards in relation to regulation of nicotine products is further evidence that a sea change in attitudes will be required to move this issue forward. So how can we begin to open up the debate that such progress will require?

I suggest that the recent Foresight Brain Science Addiction and Drugs (BSAD) initiative gives us a great opportunity since this project has highlighted many of the paradoxes of current and future drug regulation. The action points I have listed below provide a logical set of questions that the Foresight team can ask of the relevant government departments.

Why should the tax on alcoholic beverages in a single class
e.g. beers/lagers not be graduated according to alcoholcontent as in Sweden? If the answer is that outlets would just increase their margins on these as they do on soft drinks then this could be the subject of other controls.

Why should ‘hooches’ and other alcohol-based lemonades targeted at under age drinkers not be banned?

Why should all alcohol outlets not be required to have alcohol-free beers/lagers always available?

Why is the Department of Health not actively encouraging research into alcohol antagonists and alcohol alternatives?

Why does the ACMD (the Home Office Advisory Council on the Misuse of Drugs) not have a remit to consider how to deal with the harms of alcohol and tobacco?

How can the DTI provide incentives to pharma and other companies to innovate in this area?

When will we have a seamless and integrated drug and foodstuff regulatory system?

I, and I hope all of you, look forward to the answers to these questions. I will send this piece to the Foresight Team at the Department of Trade and Industry (DTI) as feedback to their BSAD process. In addition, the Academy of Medical Sciences has been asked by the Department of Health to provide a response to the BSAD report. This will be conducted under the leadership of Sir Gabriel Horn and I shall send him my paper and your commentary. If and when I get replies to these questions, I promise to let the readers of the Journal of Psychopharmacology know!